Systems &amp; Methods for Combined Femto-Phaco Cataract Surgery

ABSTRACT

Devices to perform femtolaser ablation and phacoemulsification are physically and/or operationally combined. In some embodiments the femtolaser ablation and phacoemulsification are housed together, and in other embodiments they are housed separately, but operated through a common display screen. At least some software can be shared by the femtolaser ablation and phacoemulsification functionalities. A non-transitory computer-readable memory can provide data that can be used to operate each of at least one femtolaser ablation functionality and at least one phacoemulsification functionality.

This application is a continuation of U.S. patent application Ser. No.13/648,196, filed Oct. 9, 2012, which claims the benefit of priority toU.S. Provisional Application No. 61/543,930, filed Oct. 6, 2011 which isincorporated herein by reference in its entirety.

FIELD OF THE INVENTION

The field of the invention is cataract surgery.

BACKGROUND

Modern cataract surgery is commonly performed using phacoemulsification,which is colloquially known as “phaco”. In that process the internallens of an eye is emulsified with an ultrasonic handpiece, and thedetritus is aspirated from the eye. Aspirated fluids are replaced withirrigation of balanced salt solution. As with other cataract extractionprocedures, an intraocular lens implant (IOL), is placed into theremaining lens capsule. Seehttp://en.wikipedia.org/wiki/Phacoemuisification.

The referenced Wikipedia article, as well as all other extrinsicmaterials discussed herein, are incorporated by reference in theirentirety. Where a definition or use of a term in an incorporatedreference is inconsistent or contrary to the definition of that termprovided herein, the definition of that term provided herein applies andthe definition of that term in the reference does not apply.

The phaco probe is an ultrasonic handpiece with a titanium or steelneedle. The tip of the needle vibrates at ultrasonic frequency to sculptand emulsify the cataract, while the pump aspirates particles throughthe tip. In some techniques, a second fine steel instrument called a“chopper” is used from a side port to help with chopping the nucleusinto smaller pieces. The cataract is usually broken into two or fourpieces and each piece is emulsified and aspirated out with suction. Thenucleus emulsification makes it easier to aspirate the particles. Afterremoving all hard central lens nucleus with phacoemulsification, thesofter outer lens cortex is removed with suction only.

Phacoemulsification surgery involves the use of a machine withmicroprocessor-controlled fluid dynamics. Emulsification power appliedthrough the probe, vacuum strength of the aspirator, and other operatingparameters of the phaco device are controlled through software. Examplesof graphic user interfaces of popular phacoemulsification software aredepicted in prior art FIGS. 1 and 2.

Before phacoemulsification can be performed, one or more incisions aretypically made in the eye to allow the introduction of surgicalinstruments. The surgeon then removes the anterior face of the capsulethat contains the lens inside the eye. During that part of theprocedure, difficulties sometimes arise during the incision portion ofthe procedure, potentially causing damage to the eye.

It is known to use femtosecond laser pulses to make incisions into theeye, and recently devices are available for remediating cataracts usingfemtolaser ablation. One device currently in the marketplace foraccomplishing that is Technolas Perfect Vision's™ VICTUS™ FemtosecondLaser Platform. Seehttp://www.technolaspv.com/dasat/index.php?cid=100858. Femtolaserablation of cataracts can remove even fairly large cataracts quitequickly, but (1) some portions of cataract can remain, requiringphacoemulsification, and (2) detritus must still be removed usingirrigation and aspiration.

Currently, cataract remediation using femtolaser ablation followed byphacoemulsification is performed by two entirely separate machines,requiring translocation and re-setup of the patient. This increases thetime required for the procedure, and can cause undue stress on thepatient.

Thus, there is a need to combine femtolaser ablation andphacoemulsification either in the same device, or at least in separatedevices that are operated using a combined software platform.

SUMMARY OF THE INVENTION

The inventive subject matter provides apparatus, systems and methods inwhich devices to perform femtolaser ablation and phacoemulsification arephysically and/or operationally combined.

In one aspect, at least one subsystem of the femtolaser ablationfunctionality is housed in a common housing with at least one subsystemof the phacoemulsification functionality.

In another aspect, a display screen displays both a first graphical userinterface for the femtolaser ablation functionality and a secondgraphical user interface for the phacoemulsification functionality.

In another aspect, software includes instructions disposed on anon-transitory computer-readable medium that are common to operation ofboth the femtolaser ablation functionality and the phacoemulsificationfunctionality.

In another aspect a non-transitory computer-readable memory providesdata that can be used to operate each of the femtolaser ablationfunctionality and the phacoemulsification functionality.

Various objects, features, aspects and advantages of the inventivesubject matter will become more apparent from the following detaileddescription of preferred embodiments, along with the accompanyingdrawing figures in which like numerals represent like components.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a screen shot of a prior art graphical user interface for aphacoemulsification device.

FIG. 2 is a screen shot of an alternative prior art graphical userinterface for a phacoemulsification device.

FIG. 3 is a prior art representation of the phacoemulsification deviceof FIGS. 1 and 2.

FIG. 4 is a prior art representation of a display of thephacoemulsification device of FIGS. 1 and 2, showing an eye duringphacoemulsification.

FIG. 5 is a prior art representation of a display of thephacoemulsification device of FIGS. 1 and 2, showing an eye duringaspiration.

FIG. 6 is a prior art screen shot of a prior art graphical userinterface for a femtolaser ablation device.

FIG. 7 is a screen shot of another prior art graphical user interface ofthe femtolaser ablation device of FIG. 3.

FIG. 8 is a prior art representation medical personnel using thefemtolaser ablation device of FIGS. 6 and 7.

FIG. 9 is a prior art representation medical personnel using thefemtolaser ablation device of FIGS. 6 and 7.

FIG. 10 is another prior art representation of a femtolaser ablationdevice.

FIG. 11 is a schematic of a graphical user interface of softwareconfigured to control both a femtolaser ablation device and aphacoemulsification device.

FIG. 12 is a schematic of the graphical user interface of FIG. 11,showing a menu of procedures that can be selected for the femtolaserablation device.

FIG. 13 is a schematic of the graphical user interface of FIG. 11,showing a menu of procedures that can be selected for thephacoemulsification device.

FIG. 14 is a schematic of the graphical user interface of FIG. 11,concurrently showing menus of procedures that can be selected for thefemtolaser ablation device and the phacoemulsification device

FIG. 15 is a schematic of a graphical user interface concurrentlyshowing menus of procedures that can be selected for a device thatcombines femtolaser ablation functionality and phacoemulsificationfunctionality.

FIG. 16 is a schematic of a device that combines femtolaser ablationfunctionality and phacoemulsification functionality, using a common GUIcontrol platform.

FIG. 17 is a schematic of a device that utilizes a common GUI controlplatform to control physically separate femtolaser ablation andphacoemulsification devices.

DETAILED DESCRIPTION

The following discussion provides example embodiments of the inventivesubject matter. Although each embodiment represents a single combinationof inventive elements, the inventive subject matter is considered toinclude all possible combinations of the disclosed elements. Thus if oneembodiment comprises elements A, B, and C, and a second embodimentcomprises elements B and D, then the inventive subject matter is alsoconsidered to include other remaining combinations of A, B, C, or D,even if not explicitly disclosed.

As used herein, and unless the context dictates the contrary, all rangesset forth herein should be interpreted as being inclusive of theirendpoints, and open-ended ranges should be interpreted to includecommercially practical values. Similarly, all lists of values should beconsidered as inclusive of intermediate values unless the contextindicates the contrary.

As seen in FIGS. 11-15, it is contemplated that a single GUI and/orsoftware can combine control of ophthalmic phacoemulsification andfemtolaser functionalities for cataract removal. These can be combinedin many diverse ways for surgical use on at least one of a computertouch screen, a set of dedicated buttons, a foot pedal, and a voiceinterface.

FIG. 11 is a schematic of a graphical user interface of softwareconfigured to control both a femtolaser ablation device and aphacoemulsification device. The platform can be local to one or more ofthe devices, and can alternatively or additionally be at least partiallydisposed on one or more distal servers (e.g., cloud, PaaS, IaaS, SaaS,etc.). Each of the devices shown in the figures should be interpreted asincluding electronics and software needed to operate the device, and thesoftware should be interpreted as capable of reading and utilizing datafrom one or more databases.

Devices shown in the figures with connecting lines should be interpretedas being at least functionally coupled to one another, and in someembodiments physically coupled to one another. Thus, a display deviceshown with a connecting line to a femtolaser ablation device should beinterpreted as being at least electronically coupled to one another. Asused herein, and unless the context dictates otherwise, the term“coupled to” is intended to include both direct coupling (in which twoelements that are coupled to each other contact each other) and indirectcoupling (in which at least one additional element is located betweenthe two elements). Therefore, the terms “coupled to” and “coupled with”are used synonymously. The terms “coupled to” and “coupled with” arealso use euphemistically to mean “communicatively coupled with” in anetworking sense where at least two networked elements are able tocommunicate with each other over a network possibly via one or moreintermediary devices.

It should be noted that any language directed to a computer or softwareplatform should be read to include any suitable combination of computingdevices, including servers, interfaces, systems, databases, agents,peers, engines, controllers, or other types of computing devicesoperating individually or collectively. One should appreciate thecomputing devices comprise a processor configured to execute softwareinstructions stored on a tangible, non-transitory computer readablestorage medium (e.g., hard drive, solid state drive, RAM, flash, ROM,etc.). The software instructions preferably configure the computingdevice to provide the roles, responsibilities, or other functionality asdiscussed below with respect to the disclosed apparatus. In especiallypreferred embodiments, the various servers, systems, databases, orinterfaces exchange data using standardized protocols or algorithms,possibly based on HTTP, HTTPS, AES, public-private key exchanges, webservice APIs, known financial transaction protocols, or other electronicinformation exchanging methods. Data exchanges preferably are conductedover a packet-switched network, the Internet, LAN, WAN, VPN, or othertype of packet switched network.

FIG. 12 is a schematic of the graphical user interface of FIG. 11,showing a menu of procedures that can be selected for the femtolaserablation device. These are exemplary procedures only, and contemplatedfemtolaser GUI interfaces may list other or additional procedures. Oneshould also appreciate that each of FIGS. 12-15 are merely schematics,and commercial embodiments of the interfaces would be much more detailedand user friendly, such as along the lines of that shown in FIG. 1 or 2.

FIG. 13 is a schematic of the graphical user interface of FIG. 11,showing a menu of procedures that can be selected for thephacoemulsification device.

FIG. 14 is a schematic of the graphical user interface of FIG. 11,concurrently showing menus of procedures that can be selected forseparate femtolaser ablation and phacoemulsification devices.

FIG. 15 is a schematic of a graphical user interface concurrentlyshowing menus of procedures that can be selected for a device thatcombines femtolaser ablation functionality and phacoemulsificationfunctionality. This interface differs from that shown in FIG. 14 becausethe listing of functionalities is customized in some manner, for exampleby including custom functionalities not programmed into off-the-shelfdevices, and/or by hiding functionalities that might otherwise beavailable. Such customization of main menu and/or submenu procedures forphaco and femto could be arranged by the manufacturer and/or or surgeonin an order that is thought to best fit the process of cataract removaland soft lens insertion for a particular practitioner or office.

FIG. 16 is a schematic of a device that combines femtolaser ablationfunctionality and phacoemulsification functionality, using a common GUIcontrol platform. FIG. 17 is a schematic of a device that utilizes acommon GUI control platform to control physically separate femtolaserablation and phacoemulsification devices. Each of the interfaces ofFIGS. 12-15 could be used with each of the embodiments shown in FIGS. 16and 17.

It should be apparent to those skilled in the art that many moremodifications besides those already described are possible withoutdeparting from the inventive concepts herein. The inventive subjectmatter, therefore, is not to be restricted except in the scope of theappended claims. Moreover, in interpreting both the specification andthe claims, all terms should be interpreted in the broadest possiblemanner consistent with the context. In particular, the terms “comprises”and “comprising” should be interpreted as referring to elements,components, or steps in a non-exclusive manner, indicating that thereferenced elements, components, or steps may be present, or utilized,or combined with other elements, components, or steps that are notexpressly referenced. Where the specification claims refers to at leastone of something selected from the group consisting of A, B, C . . . andN, the text should be interpreted as requiring only one element from thegroup, not A plus N, or B plus N, etc.

What is claimed is:
 1. A system that combines femtolaser ablationfunctionality and phacoemulsification functionality at least one ofphysically and operationally.
 2. The system of claim 1, wherein at leastone subsystem of the femtolaser ablation functionality is housed in acommon housing with at least one subsystem of the phacoemulsificationfunctionality.
 3. The system of claim 1, further comprising a displayscreen that displays a first graphical user interface for the femtolaserablation functionality and a second graphical user interface for thephacoemulsification functionality.
 4. The system of claim 1, furthercomprising instructions disposed on a non-transitory computer-readablemedium common to operation of both the femtolaser ablation functionalityand the phacoemulsification functionality.
 5. The system of claim 1,further comprising a non-transitory computer-readable memory thatprovides data that can be used to operate each of the femtolaserablation functionality and the phacoemulsification functionality.